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Objectives: Newly developed transcutaneous BAHA Attract systems have gained increasing popularity. To reduce surgical time and possible postoperative complications, the originally recommended surgical technique and implant loading have been modified. Materials and methods: In a preliminary study with MRA, Doppler ultrasound measurement and cadaver dissection (n=50 subject), we have proved, that the prevalence of major arteries is low in the upper-posterior area, although large in proximity to the auricle region. Therefore, in our 47 BAHA Attract implantees, incision line was performed in the superior-posterior region of the temporal area. Also implant loading was modified to avoid bone surface drilling. Patients have been followed for 2 years postoperatively. A one page questionnaire -focusing on the hearing performance/ wearing/comfort- was filled in all case. Audiological outcome was tested and compared in the two Attract groups: in Group1 (n=11) implant loading was performed in the recommended way, in Group2 (n=10) the implant was screwed out with 180o-360o (~0.5-1mm) and periosteum was preserved around the implant. Results: Implantation was performed mostly under local anesthesia, average surgical time was ~ 15 min. Sound processor loading could be performed at the 4th week, but necessary magnet strength was lower, compared to the literature. Pain and tissue numbness was negligible according to the result of the questionnaire. Skin irritation (n=4) was solved with less strong magnet. Severe skin complication was detected in only 1 of the total 47 cases. Long term follow-up showed no further complication. Postoperative audiometry showed significantly better results compared to preoperative tests in both implanted groups. There was no significant difference between the groups in pure tone audiometry results. Conclusion: Based on our studies, superior-posterior incision line preserves the neurovascular integrity of the implant area, contributes to less postoperative complication, and provides better wearing comfort/aesthetic outcome. [ABSTRACT FROM AUTHOR]